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Improving Asthma Outcomes
Session 300, February 15, 2019
Lindsay Neptune, Nurse Practitioner, Open Door Family Medical Centers
Denise Garcia Egan, Director of Clinical Business Intelligence, Open Door Family Medical Centers
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Lindsay Nepture, APRN, PPCNP-BC
Has no real or apparent conflicts of interest to report.
Denise Garcia Egan, MPH
Has no real or apparent conflicts of interest to report.
Conflict of Interest
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• Overview of Open Door Family Medical Centers
• Why focus on Asthma?
• Visit Planning
• Proactive Outreach
• Measurement and Reporting
• Outcomes
• Questions
Agenda
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• Identify tools for managing asthma and other chronic diseases
through EHR templates
• Integrate reports for both visit planning and population health
management
• Manage the dissemination and use of outcome data
Learning Objectives
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1985 – Open Door Sleepy Hollow
1994 – Open Door Foundation
1995 – Open Door Port Chester
2003 – School-Based Health Centers
2006 – Open Door Mt. Kisco
2007 – eClinicalWorks Implementation
2013 – Open Door Brewster
2015 – Mobile Dental Unit (K–12)
Family Medicine Residency Program
2016 – Relevant adoption
2017 – Open Door Mamaroneck
2018 – Brand new Open Door Sleepy Hollow
Dental Residency Program
Open Door was founded as a free clinic in 1972
to address health inequities in Ossining.
History of Open Door
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Asthma
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Asthma Prevalence
0%
2%
4%
6%
8%
10%
12%
14%
16%
2016
Open Door
New York State
Open Door's School-
Based Health Centers
Note: Open Door and
NYS stats represent
all ages, SBHC are
5 to 18-year-olds.
Data Source: HRSA UDS National Health Center Data, 2016
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School-Based Health Center Asthma Metrics
Data Sources: Open Door Family Medical Centers; Port Chester School District, Westchester County Sparks Data 2006-20
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Plan and Measurement Metrics
Reduce missed school days by
50%.
Increase the documented levels of
asthma severity to 80%.
Increase the percentage of
persistent asthmatics prescribed
inhaled corticosteroids to 90%.
Increase updated Asthma Action
Plans to 100%.
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Tools to Improve Care
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Our Care Model
• eClinical Works
• Relevant Data Warehouse,
Dashboards and Asthma
Registry
Clinical Information
Systems
• Reminder Calls
• Visit Planning Reports
Decision Support
• Templates
• Order Set
Delivery System
Design
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Visit Planning
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Visit Planning Workflow
VP
Report
• Reviewed before morning and afternoon
sessions by care team
• Alerts team to gaps in care
Team
Huddles
• Initiated by care team to review patient
needs
• Support team is empowered through
standing orders
Improve
Care and
Efficiency
• Support team can care for patient before
clinician enters the room
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Visit Planning Report
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Asthma Visit Templates
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Asthma Visit Templates
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Asthma Action Plan
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Asthma Education Embedded in eCW
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Proactive Outreach
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Reports and Registries
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Quality Measure Dashboards
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Pay For Performance:
Provider Report Cards
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SBHC Asthma Metrics
Data Source: Open Door Family Medical Centers, Port Chester School District
*Westchester County age 0-17 ED visit data 2010-2012 SPARCS data as of Nov 2013
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Control Line
Upper Control Line
Lower Control Line
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10
20
30
40
50
60
70
80
90
100
Percent Compliant
Asthma Registry Implementation
Relevant Quality Measures
SBHC Asthma Action Plans
